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Work Activitv Work Order Pa9e 1 <br />9/ze/zoia ii:2o <br />ISSUed By CSG CAVANAH, SHANE G. <br />Issued Department Pw PueLlc woRKs <br />Date Issued 512912014 <br />F�nd ao� Account s Program »o Function ��y Activity e�s <br />Program <br />TIUC REPAIR JS INCH 6106 DEXTER AVE 770119675 <br />Work Order No 20141276 f f0)0Ci Activity Type CORRECTIVE MARdTENANCE $fBIUS CL <br />Status s�zQnoia Time i33s Original WO Billing <br />Customer Information <br />Customer Name <br />Address Street <br />Apartment No City <br />State Z�p <br />Subdivision <br />Phone No ( ) - Ext <br />Second Phone ( ) • Ext <br />E-Mail Address <br />Problem Information <br />Address Street <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Initiated From <br />UtiGty Locate (USA) No <br />Assignment Information <br />Dept <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date <br />Scheduled Date <br />Route <br />Comments <br />ACtIOn Taken INSTALLED SETTER AND BOX. <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Dale <br />Pnority Es6maled Hours <br />Recommended Action <br />Approved By RJP RAPELYEA, JASON P. JOb COSt Ifl(OffT18�lOf1(YIN� <br />-- ----- .___ <br />Start Date i � Time Date Completed snnzo�a <br />-- ------ ------- <br />Completed By _ _ _ _ _ _ _ Time Follow Up?___ <br />Permit No <br />